Rigorous Intervention Program May Reverse Diabetes

Intense weight-loss and lifestyle interventions are associated with a partial or complete remission of diabetes, according to a new study.

Researchers at the US Centers for Disease Control and Prevention (CDC; Atlanta, GA, USA) conducted an observational analysis of a 4-year randomized controlled trial to examine the association of a long-term intensive lifestyle intervention (ILI) with diabetes support and education (DSE) control. The study involved 4,503 US adults with body mass index (BMI) of 25 or higher and type 2 diabetes who were assigned to receive ILI (2,241 participants) or DSE (2,262). The main outcome measures were partial or complete remission of diabetes, defined as transition to a fasting plasma glucose level lower than 126 mg/dL and hemoglobin A1c lower than 6.5% with no antihyperglycemic medication.

The ILI weight-loss intervention included weekly group and individual counseling for the first six months, focused on reducing caloric intake, decreasing consumption of total and saturated fats, and increasing physical activities; this was followed by three sessions per month for the second six months and twice-monthly sessions over years 2-4. Participants were also offered liquid meal replacements to help with dietary goals. In the DSE group, participants were given three group sessions annually that offered information on diet, physical activity, and social support.

The results showed that the patients engaged in the ILI weight-loss and lifestyle intervention were more likely to experience any remission after one year, and were more likely to see that remission continuously sustained over three years of measurements. In addition to losing more weight, the ILI group had greater increases in fitness, and higher rates of complete remission, while significantly fewer participants in the ILI who experienced remission returned to clinical diabetes status at each point of follow-up. The study was published on December 19, 2012, in the Journal of the American Medical Association (JAMA).

“An intensive lifestyle intervention was associated with a greater likelihood of partial remission of type 2 diabetes compared with diabetes support and education,” concluded lead author Edward Gregg, PhD, and colleagues. “Weight-loss intervention was particularly effective in those whose diabetes is of short duration, those who have lower hemoglobin A levels, and who do not yet require insulin therapy.”

Related Links:
US Centers for Disease Control and Prevention